Use of equilibrium (gated) radionuclide ventriculography to quantitate left ventricular output in patients with and without left-sided valvular regurgitation.

Abstract

The accuracy with which left ventricular output can be estimated by equilibrium radionuclide ventriculography was examined. After red blood cells were labeled in vivo, left ventricular end-diastolic and end-systolic count rates and the count rate in 5 ml of the patient''s blood were measured. After estimating the average ratio of counting efficiency for the left ventricle to counting efficiency for the blood sample (ELV/ES) in 6 patients, left ventricular output in 26 other patients as (left ventricular activity ejected per minute divided by activity per liter of blood) divided by the previously estimated ELV/ES was calculated. Radionuclide left ventricular output closely approximated Fick cardiac output (r = 0.94) in patients without mitral or aortic regurgitation and exceeded Fick cardiac output in all patients with valvular regurgitation. Regurgitant fraction, calculated as the difference between the radionuclide and Fick outputs divided by the radionuclide output, correlated with the severity of regurgitation as assessed angiographically. The equilibrium radionuclide ventriculogram is an excellent means for noninvasive estimation of left ventricular output.